Changes in hospital consumption of opioid and non-opioid analgesics after colorectal endometriosis surgery

Adrien Crestani, Marjolaine Le Gac, Amine Bibaoune, Yohann Dabi, Kamila Kolańska, Clément Ferrier, Sofiane Bendifallah, Cyril Touboul, Émile Daraï
In: Research Square · 2023 · doi:10.21203/rs.3.rs-2981972/v1 · W4381279915
preprint OA: green CC0 ⤵ 1 in-corpus citation
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This retrospective study analyzed postoperative analgesic consumption after colorectal endometriosis surgery, finding procedure type impacted acetaminophen and nefopam use, robotic surgery led to higher tramadol use, and a trend away from tramadol towards ketoprofen occurred over time.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This retrospective study analyzed postoperative in-hospital analgesic consumption in 162 adults undergoing colorectal surgery for endometriosis at Tenon University Hospital (Paris) from 2019–2021, comparing robotic versus conventional laparoscopy and examining opioid versus non-opioid use. Patients received a standardized stepwise regimen (systematic acetaminophen, then ketoprofen or nefopam as needed, with tramadol and morphine for resistant pain), and analgesic intake was extracted from prescription/delivery records. The authors found that surgical type influenced acetaminophen and nefopam consumption, robotic surgery was associated with higher total tramadol use than conventional laparoscopy, and analgesic prescribing shifted over time with tramadol markedly decreasing while ketoprofen increased by 2021; only history of abdominal surgery and operating year were independently associated with opioid use. A major caveat is that patients were not randomized to robotic versus conventional laparoscopy (assignment depended on robotic theatre availability), and the study reflects medication consumption during hospitalization. This paper is centrally about endometriosis — it specifically evaluates hospital opioid versus non-opioid analgesic consumption after colorectal endometriosis surgery.

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Abstract

Abstract Background The aim of this study was to analyze postoperative consumption of analgesics during hospitalization following colorectal surgery for endometriosis. Methods: We conducted a retrospective study at Tenon University Hospital, Paris, France from February 2019 to December 2021. Results One hundred sixty-two patients underwent colorectal surgery: 89 (55%) by robotic and 73 (45%) by conventional laparoscopy. The type of procedure had an impact on acetaminophen and nefopam consumed per day: consumption for colorectal shaving, discoid resection and segmental resection was, respectively, 2(0.5), 2.1(0.6), 2.4(0.6) g/day (p = 10 − 3), and 25(7), 30(14), 31(11) mg/day (p = 0.03). The total amount of tramadol consumed was greater following robotic surgery compared with conventional laparoscopy (322(222) mg vs 242(292) mg, p = 0.04). We observed a switch in analgesic consumption over the years: tramadol was used by 70% of patients in 2019 but only by 7.1% in 2021 (p < 10 − 3); conversely, ketoprofen was not used in 2019, but was consumed by 57% of patients in 2021 (p < 10 − 3). A history of abdominal surgery (OR = 0.37 (0.16–0.78, p = 0.011) and having surgery in 2020 rather than in 2019 (OR = 0.10 (0.04–0.24, p < 10 − 3 )) and in 2021 than in 2019 (OR = 0.08 (0.03–0.20, p < 10 − 3 )) were the only variables independently associated with the risk of opioid use. Conclusion We found that neither clinical characteristics nor intraoperative findings had an impact on opioid consumption in this setting, and that it was possible to rapidly modify in-hospital analgesic consumption modalities by significantly reducing opioid consumption in favor of NSAIDS or Nefopam.

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endometriosis

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